Sports Injury

Sports Injury physiotherapy services in Blackwood. While engaging in sporting or exercise activities, injuries can occur due to lack of conditioning, improper technique or failing to do pre and post stretching.

Physiotherapy is one of the most effective treatment options for sports injuries, providing diagnosis and understating the biomechanics of the injury can help to achieve appropriate return to sport plans and rehabilitation programs.

Rehabilitation is the restoration of optimal form (anatomy) and function (physiology).

It is a process designed to minimise the loss associated with acute injury or chronic disease, to promote recovery, and to maximize functional capacity, fitness and performance.

Musculoskeletal injuries are an inevitable result of sport participation.  Tissue injury from sports can be classified as macro-traumatic and micro-traumatic. Macro-traumatic injuries are usually due to a strong force – such as a fall, accident, collision or laceration – and are more common in contact sports. Micro-traumatic injuries are chronic injuries that result from overuse of a structure such as a muscle, joint, ligament, or tendon. This type of injury is more common in sports such as swimming, cycling and rowing. The process of rehabilitation should start as early as possible after an injury and form a continuum with other therapeutic interventions. It can also start before or immediately after surgery when an injury requires a surgical intervention.

Rehabilitation Plan

The rehabilitation plan must take into account the fact that the objective of the patient is to return to the same activity and environment in which the injury occurred. Functional capacity after rehabilitation should be the same, if not better, than before injury.
The ultimate goal of the rehabilitation process is to limit the extent of the injury, reduce or reverse the impairment and functional loss, and prevent, correct or eliminate altogether the disability.

Principles

Principles are the foundation upon which rehabilitation is based. Here are seven principles of rehabilitation

Avoid aggravation. It is important not to aggravate the injury during the rehabilitation process.

Timing. The therapeutic exercise portion of the rehabilitation program should begin as soon as possible—that is, as soon as it can occur without causing aggravation. The sooner patients can begin the exercise portion of the rehabilitation program, the sooner they can return to full activity. Following injury, rest is sometimes necessary, but too much rest can actually be detrimental to recovery.

Compliance. Without a compliant patient, the rehabilitation program will not be successful. To ensure compliance, it is important to inform the patient of the content of the program and the expected course of rehabilitation.

Individualisation. Each person responds differently to an injury and to the subsequent rehabilitation program. Even though an injury may seem the same in type and severity as another, undetectable differences can change an individual’s response to it.

Specific sequencing. A therapeutic exercise program should follow a specific sequence of events. This specific sequence is determined by the body’s physiological healing response.

Intensity. The intensity level of the therapeutic exercise program must challenge the patient and the injured area but at the same time must not cause aggravation. Knowing when to increase intensity without overtaxing the injury requires observation of the patient’s response and consideration of the healing process.

Total patient. It is important for the unaffected areas of the body to stay finely tuned. This means keeping the cardiovascular system at a pre-injury level and maintaining range of motion, strength, coordination, and muscle endurance of the uninjured limbs and joints. The whole body must be the focus of the rehabilitation program, not just the injured area.

Components

Regardless of the specifics of the injury, however, here are fundamental components that need to be included in all successful rehabilitation programs:

Pain Management

Medications are a mainstay of treatment in the injured athlete – both for their pain relief and healing properties. It is recommended that they need to be used judiciously with a distinct regard for the risks and side effects as well as the potential benefits, which include pain relief and early return to play.

Flexibility and Joint Range Of Motion (ROM)

Injury or surgery can result in decreased joint ROM. It is common for flexibility to be diminished as a result of muscle spasm, inflammation, swelling and pain. Flexibility training is an important aspect of rehabilitation in order to minimise the decrease in joint ROM. A variety of stretching techniques can be used in improving range of motion.

Strength and Endurance

Musculoskeletal injuries could result in muscle hypotrophy and weakness, loss of aerobic capacity and fatigability. During rehabilitation it is important to try to maintain cardiovascular endurance with exercise programmes that have relatively high intensity and short rest periods.

Coordination

Coordination can be defined as ‘the capacity to perform movements in a smooth, precise and controlled manner’. Improving coordination depends on repeating the positions and movements associated with different sports and correct training.

Functional Rehabilitation

The goal of function-based rehabilitation programmes is the return of the athlete to optimum athletic function.

Stages of Rehabilitation

Initial Stage of Rehabilitation
This phase lasts approximately 4-6 days.  The body’s first response to an injury is inflammation. It’s main function is to defend the body against harmful substances, dispose of dead or dying tissue and to promote the renewal of normal tissue. The goals during the initial phase of the rehabilitation process include limitation of tissue damage, pain relief, control of the inflammatory response to injury, and protection of the affected anatomical area.

Control pain and swelling
Primary treatment in initial phase of rehabilitation is RICE. It is the term that stands for Rest, Ice, Compression and Elevation. RICE can be used immediately and 24 to 48 hours after many muscle strains, ligament sprains, or other bruises and injuries.

Intermediate Stage of Rehabilitation
This phase lasts from day 5 to 8-10 weeks. After the inflammatory phase, the body begins to repair the damaged tissue with similar tissue, but the resiliency of the new tissue is low. Repair of the weakened injury site can take up to eight weeks if the proper amount of restorative stress is applied, or longer if too much or too little stress is applied.

Joint ROM and Muscle Conditioning
The goals during the second phase of rehabilitation include the limitation of the impairment and the recovery from the functional losses. Early protected motion hastens the optimal alignment of collagen fibres and promotes improved tissue mobility. Exercise to regain flexibility, strength, endurance, balance, and coordination become the central component of the intervention.

Advanced Stage of Rehabilitation
This phase begins at around 21 days and can continue for 6-12 months. This phase of rehabilitation represents the start of the conditioning process needed to return to sports training and competition. Understanding the demands of the particular sport becomes essential as well as communication with the coach. This phase also represents an opportunity to identify and correct risk factors, thus reducing the possibility of re-injury.

Functional Training
The combination of clinic-based and sport-specific functional techniques will provide an individualised, sport-specific rehabilitation protocol for the athlete. Rehabilitation and reconditioning exercises must be functional to facilitate a return to competition.

Return to Sport
At some point in the recovery process, athletes return to strength and conditioning programs and resume sport-specific activities in preparation for return to play. The transition is important for several reasons. First, although the athlete may have recovered in medical terms (ie, improvements in flexibility, range of motion, functional strength, pain, neuromuscular control, inflammation), preparation for competition requires the restoration of strength, power, speed, agility, and endurance at levels exhibited in sport.

Monitoring
Appropriate monitoring of training load can provide important information to athletes and coaches; however, monitoring systems should be intuitive, provide efficient data analysis and interpretation, and enable efficient reporting of simple, yet scientifically valid, feedback.